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1790396737
DANIEL IVANOV
BOSTON, MA
NPI
1790396737
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: MA 3043)
Enumeration Date
2020-08-13
Last Update Date
2020-08-13
Business Address
DANIEL IVANOV
139 CHARLES ST STE 388
BOSTON, MA 02114-3282
Phone number: 203-529-5123
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Mailing Address
DANIEL IVANOV
16 TAYLOR PL
WESTPORT, CT 06880-4313
Phone number: 203-529-5123
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